Pcn228 the Importance of the Overall Survival Endpoint in Eu Hta Decision-Making

Abstract

Scoring on ASCO and ESMO frameworks for 102 advanced oncology drugs were taken from Cherny 2018. Corresponding final appraisal documents by NICE were reviewed. Data were extracted for indication, comparators, clinical benefit assessment, toxicity, quality of life, and cost-effectiveness. NICE committee's final decision was recorded: recommended or not, with restriction in indication or with a patient access scheme (PAS) or on the cancer drugs fund (CDF). The relationship between ASCO/ESMO scores and NICE recommendation was investigated. Results: 79% of the 102 drugs included in Cherny 2018 were assessed by NICE; 45% were recommended by NICE, 22% were with PAS and 12% on the CDF. Of the recommended treatments, 82% and 93% were associated with a moderate to high clinical benefit score on ASCO (.40) and ESMO (.3), respectively. Treatments with restricted recommendation based on indication and on CDF were associated with the highest mean ASCO (54) and ESMO (4) benefit score. Cost-effectiveness was less correlated with clinical scoring, potentially suggesting that pricing does not fully reflect clinical benefit. The cost-effectiveness analysis was limited by the confidential nature of the final agreed price. Conclusions: An association was found between NICE recommendations and clinical benefit assessments by ASCO and ESMO despite the difference in performance criteria, clinical evidence, comparator choice, disease burden, and cost-effectiveness, adopted by payers and clinical frameworks.